Vision Transformer MRI Model Predicts Temozolomide Resistance in Glioblastoma

Fusion model combining vision transformer MRI analysis and MGMT methylation predicted temozolomide resistance in glioblastoma with external validation AUC 0.848 (95% CI 0.673-0.964).

• Multicenter retrospective study of 314 glioblastoma patients across four centers.
• Optimal peritumoral expansion margin was 10 mm; fusion model integrated ViT-based imaging features with MGMT methylation status.
• Fusion model gave higher AUCs than MGMT alone in all validation cohorts (internal AUC 0.917, external AUCs 0.806 and 0.848).

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